Pediatric
residents at Packard awarded national grants to help teens at risk

By
KRISTA CONGER

Ask
the kids at Santa Clara County’s juvenile hall about
homelessness, and they’re likely to tell you it can mean more
than not having a place to sleep at night.

Even
those with a permanent address can suffer from the lack of a
medical home — a network of physicians and clinics to provide
regular, essential medical care for problems as diverse as sexually
transmitted diseases, depression and substance abuse.

For
some kids, their run-in with the justice system at juvenile hall
marks the first time in years their medical needs have been
evaluated and treated by professionals, such as pediatric residents
from Lucile Packard Children’s Hospital. But the benefits of
this concentrated attention often end when the child steps back
onto the streets and out of the grasp of those trying to
help.

Pediatric resident Arash Anoshiravani, MD, would like to change
that pattern.

"One
of the things we do here at Packard is that we never let patients
leave without scheduling a follow-up appointment," he said, adding
he’d like to see similar medical arrangement for kids in
juvenile hall. In addition to securing follow-up treatment at
discharge, Anoshiravani would like to distribute cards to youths
before discharge with contact information for public health
organizations and community groups that can assist at-risk
youth.

Anoshiravani’s vision of a seamless medical transition
between the justice system and the community may soon be more than
just wishful thinking, thanks in part to a recent grant from the
American Academy of Pediatrics’ Community Access to Child
Health, or CATCH, Program. Anoshiravani and another Packard
Children’s Hospital pediatrics resident, Joyce Javier, MD,
are two of only 33 recipients of CATCH grants. The grants seek to
aid pediatricians to initiate innovative, community-based proposals
to increase children’s access to health care. Anoshiravani
and Javier each received $3,000.

"This is the first time I know of that anyone at Packard
Children’s Hospital has received a CATCH grant," said Lisa
Chamberlain, MD, general pediatrics fellow. Chamberlain supervises
the required course for pediatric residents in advocacy training
that jump-started both Anoshiravani and Javier on their
projects.

While Anoshiravani is focusing his efforts on teens in trouble
with the law, Javier is aiming to prevent teen pregnancy and
sexually transmitted diseases in Asians and Pacific Islanders.
Although overall teen pregnancy rates are decreasing in California,
the numbers are more ominous when the data is broken down into
different population groups.

"One
group, Filipinas, is at particularly high risk," said Javier. Her
position as both a physician and a fellow Filipina gives her a
unique opportunity to act as a bridge between children and parents
reluctant to discuss sexual issues. "Culturally, this is a very
difficult topic," said Javier. "Many members of this community are
not even aware this is a problem."

Javier has already worked extensively with the Filipino Youth
Coalition of San Jose to target at-risk adolescents in middle and
high school. She’s planning to use her CATCH grant to
organize and fund a one-day conference for parents and teens to
outline the problems and facilitate discussion within the
community.

Anoshiravani and Javier are also both considering adding
outcomes research to their to-do list, which would enable them to
quantify potential benefits of their programs and allow future
publication of their results.

Chamberlain will continue to work with Anoshiravani and Javier
to help them focus their projects to meet the needs of the
communities they are meant to serve. Javier has taken this to heart
and plans to solicit advice and participation from those
she’s trying to help.

"I’d like to get the youth involved and find out what
they feel are the most important issues," she said.